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Medical Science Monitor Basic Research


Atypical Presentation of a Rare Parasitic Infection with Fasciola hepatica: A Multidisciplinary Case Report

Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents

Luca Rinaldi, Veronica Folliero, Luciano Restivo, Francesco Foglia, Gianluigi Franci, Annalisa Chianese, Natalina Iuliano, Serena De Luca, Barbara Guerrera, Luca Del Viscovo, Luigi Elio Adinolfi

Italy Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy

Am J Case Rep 2020; 21:e924704

DOI: 10.12659/AJCR.924704

Available online: 2020-08-10

Published: 2020-09-16


BACKGROUND: Fascioliasis is a zoonotic disease caused by Fasciola hepatica (F. hepatica). This infection is associated with a broad spectrum of clinical symptoms such as fever, eosinophilia, and gastrointestinal symptoms.
CASE REPORT: We report a case of F. hepatica abdominal mass in the peri-pancreatic region in a 58-year-old man, returned from Venezuela. The patient developed abdominal pain, nausea, anorexia, and weakness. Radiological investigations showed hepatomegaly, as well as mild intra-hepatic and extrahepatic ductal dilatation. The increase in eosinophilia, elevated total IgE titer, and anamnestic data suggested the hypothesis of parasitic infection. The diagnosis was established by high serological titer against F. hepatica.
CONCLUSIONS: The development of abdominal mass, with jaundice and dilation of the biliary tract, does not always suggest the presence of heteroplasia. Systemic parasitosis represents a not negligible event, especially considering the personal history of life in endemic areas.

Keywords: Fasciola hepatica, Parasitic Diseases, Ultrasonography